Health Promotion Strategies

Advantages of tobacco use Cessation Programs

Instances of respiratory diseases, cancer and other illnesses can be decreased through tobacco use cessation efforts. tobacco use cessation programs can provide huge opportunities for improved health.

The American Cancer Society reports that tobacco use staff members cost corporations an average of $1,429 per smoker per year in raised health care costs over non-tobacco use staff members. Implementing a tobacco use cessation program costs an average of $45 per worker per year, saving corporations an average of $1,383 per year for each worker who quits tobacco use. Additionally, the American Cancer Society reports that smokers are absent from work 50 percent more often than nonsmokers. They are also 50 percent more likely to be hospitalized and have 15 percent higher disability rates. tobacco use decreases onthe- job productivity as well. Employees who take four 10- minute tobacco use breaks a day work more than a month less per year than workers who don’t take smoke breaks.

Places to start with tobacco use cessation programs:

1.    Start a organization policy prohibiting tobacco use anywhere on the property.
2.    Provide prompts/posters to support no tobacco use policy.
3.    Policy supporting participation in tobacco use cessation activities during duty time (flex-time).
4.    Provide counseling through an individual, group, or telephone counseling program onsite.
5.    Provide counseling through a healthcare plan sponsored individual, group, or telephone counseling program.
6.    Provide cessation medications through health insurance.

Advantages of Nutrition Programs

Nutrition directly impacts nearly every aspect of physical and mental health. A healthy diet can help protect against such conditions as heart disease, diabetes, arthritis, stroke, certain cancers and depression. Obesity, which is among the most common conditions linked to diet, affects a record number of Americans.

The American Journal of Health Promotion estimates the cost of obesity to United States organization to exceed $12.5 billion in health care, sick leave, and life and disability insurance. Further, one study reports that obesity raises health care costs by 36 percent and medication costs by 77 percent. To offset the health risks of obesity and poor diet, many corporations have committed to helping staff members ensure proper nutrition and undertake weight control programs.

Popular nutrition programs:

Fruit and Vegetable Consumption
1.    Provide healthy eating reminders and prompts to staff members via multiple means (i.e. e-mail, posters, payroll stuffers, etc.).
2.    Provide appealing, low-cost fruits and vegetables in vending machines and in the cafeteria.
3.    Provide cookbooks, food preparation, and cooking classes for staff members’ families.
4.    Ensure onsite cafeterias follow healthy cooking practices and set nutritional standards for foods served that align with the United States Dietary Guidelines for Americans.
5.    Provide healthy foods at meetings, conferences, and catered events.
6.    Use point-of-decision prompts as a marketing technique to promote healthier choices.
7.    Provide healthy cooking demonstrations that teach skills (i.e. fruit and vegetable selection and preparation).
8.    Provide taste-testing opportunities at the worksite.
9.    Provide worker-led campaigns, demonstrations or programs.
10.    Provide local fruits and vegetables at the worksite (i.e. worksite farmer’s market or community-supported agriculture drop-off point).
11.    Use competitive pricing (price non-nutritious foods in vending machines and cafeterias at higher prices).
12.    Provide protected time and dedicated space away from the work area for breaks and lunch.
13.    Make kitchen equipment available to staff members.
14.    Provide an opportunity for onsite gardening if possible.

Sweetened Beverage Consumption
1.    Make water available throughout the day.
2.    Provide appealing, low-cost healthful drink options in vending machines and the cafeteria.
3.    Modify worksite vending contracts to increase the number of healthy options.
4.    Price non-nutritious beverages at a higher cost.
5.    Use point-of-decision prompts to promote healthier choices.

Portion Control
1.    Label foods to show serving size and/or nutritional content.
2.    Provide food models, food scales for weighing and pictures to help staff members assess portion size.
3.    Provide appropriate portion sizes at meetings, worksite events and in the cafeteria.

Nutrition programs in action

While many corporations address weight management through fitness initiatives, corporations are increasingly focusing on nutrition through separate programming. Recognizing the productivity boost and lowered medical expenditures that come with maintaining a healthy weight, many corporations may help pay for obesity treatments for staff members. By way of example, to improve the health of dangerously obese staff members, drug maker Wyeth reportedly pays for stomach-shrinking surgeries that carry price tags of up to $40,000.

A 2003 Society of Human Resource Management study shows that 24 percent of corporations offer weight loss programs. In Ohio, Honda offers an onsite, registered dietitian who provides individual or group consultations on weight management. Body fat analysis and body mass index (BMI) measurements are available to staff members at any time.

At Grange Insurance’s Columbus headquarters, the cafeteria chef analyzes meals and provides staff members basic nutrition information, including Weight Watchers points. Many corporations partner with the American Cancer Society to offer nutrition information through the ”5-ADay” program, which provides corporations free signage and educational materials about the importance of eating five servings of fruits and vegetables a day. The program also offers a fruit and vegetable ”frequency card” that gives staff members a free portion of fruit or vegetables after he or she has purchased a preset number.

Advantages of Physical Fitness Initiatives

Exercise reduces weight, lowers risks of heart attack and stroke, helps to control blood pressure and diabetes, and improves mood. Studies increasingly show that exercise may also help reduce the occurrence of certain types of cancer. Researchers at the Centers for Disease Control and Prevention (CDC) recently documented another major advantage: exercise improves the health of the nation’s medical care expenditures.3 According to the CDC, physically active individuals incur $865 less per year in medical costs than inactive employees.

Dr. Michael Moore, vice president and chief medical director at Nationwide Insurance in Columbus, maintains that exercise is the most effective tool in health maintenance. “If you could prescribe exercise in a pill, it would be the number-one prescribed treatment in the world,” he said. In step with Dr. Moore’s prescription, nearly one-third of United States corporations help staff members pay for gym memberships, according to an Associated Press report. Subsidizing gym memberships is just one way corporations promote active lifestyles.

Popular Physical Fitness Initiatives:

1.    Allow access to on- and off- worksite gyms and recreational activities before, during, and after work hours.
2.    Provide and promote participation in after work recreation or leagues.
3.    Provide cash incentives or decreased insurance costs for participation in physical activity and/or weight management or maintenance activities.
4.    Provide shower and/or changing facilities onsite.
5.    Provide outdoor exercise areas such as fields and trails for worker use.
6.    Provide bicycle racks in safe, convenient, and accessible locations.
7.    Provide onsite fitness opportunities, such as group classes or personal training.
8.    Provide an onsite exercise facility.
9.    Start programs that have strong social support systems and incentives, such as:
• Buddy or team physical activity goals
• Initiatives that involve workers and family
• Initiatives to promote physical activity, such as pedometer walking challenges
• Explore discounted or subsidized memberships at local health clubs, recreation centers, or YMCAs
10.     Provide flexible work hours to allow for physical activity during the day.
11.    Support physical activity breaks during the workday, such as stretching or walking.
12.    Host walk-and-talk meetings.
13. Map out onsite trails or nearby walking routes and destinations.
14. Have staff members map out their own biking or walking route to and from work.
15. Post motivational signs at elevators and escalators to promote stair usage.
16. Provide exercise/physical fitness messages and information to staff members.
17. Provide or support recreation leagues and other physical activity events onsite or in the community.
18. Begin worker activity clubs such as walking or bicycling clubs.
19. Provide onsite child care facilities to facilitate physical activity.
20. Sponsor a bike to work day and reward staff members who participate.
21. Start a box and solicit fitness and health tips.

Wellness programming means different things to different corporations. Effective wellness initiatives can be as simple as bringing baskets of fresh fruit into break rooms to encourage better eating. They can be as extensive as building fitness facilities onsite or paying for obesity treatments.

A driving factor behind the push toward wellness spans corporations of all types, sizes and cultures: that is, health care expenses are spilling over the business belt buckle. The annual cost of medical services in the United States is increasing at seven times the rate of inflation. And the rise in medical costs is one boom pundits expect our economy to sustain.1

This trend makes it increasingly challenging for corporations to maintain current levels of insurance coverage. In 2003, health care inflation forced 65 percent of corporations to increase staff members’ share of health costs.

Seventy-nine percent of large firms said they will increase workers’ share of health costs in 2004.2 But with lost benefits and increased financial burdens come lost morale and productivity.

Corporations are searching for another way. While corporations cannot control many of the supply-side elements contributing to increasing health care costs—malpractice insurance rates, the nursing shortage—they can help curb demand. That’s why efforts are being redirected from illness to wellness.

The case for Employee Health Promotion Programs is supported by an ever growing body of evidence demonstrating the high costs associated with controllable health risks:

• One study reports that obesity raises health care costs by 36 percent and medication costs by 77 percent.
• Michigan officials estimate physical inactivity cost the state nearly $8.9 billion in 2002, a cost estimated to be largely borne by corporations through insurance premiums and lost productivity.
• The not-for-profit National Committee for Quality Assurance reports that the estimated average cost for postnatal care for women who did not receive prenatal care was $2,341 more than for women who had. And the indirect costs of unhealthful behavior can be just as high.

Data shows that healthier staff members are more productive, spending more time at work and showing increased “presenteeism,” or productivity, while there. Further, healthier staff members use fewer medical services. The five leading causes of death in the United States — heart disease, cancer, stroke, chronic obstructive pulmonary disease and diabetes —  are directly linked to unhealthy lifestyles. Clearly, encouraging healthful habits presents an opportunity to improve staff members’ well being, reduce the need for health care services and help control costs.

Offering worker wellness benefits — large or small — represents an intersection between business social responsibility and responsibility to stakeholders. Between worker health and corporate health. It’s often the right thing to do for staff members and corporations.

Research by Traveler’s Corp. shows a $3.40 return for every dollar invested in Employee Health Promotion Programs. For many corporations, the choice to offer worker wellness benefits is easy—one where conscience and pragmatism align.

The challenge arises in selecting the programs that will deliver the most impact based on trends in your staff members’ health risks and medical claims costs. From large corporations to the corner deli, organization owners welcome ways to boost productivity, reduce absenteeism and cut costs. Likewise, Employee Health Promotion Programs can range from modest to elaborate.

In determining where to focus a organization’s limited resources, looking at benefits, costs and best practices is a good starting point. This section profiles six aspects of wellness and explores their benefits to staff members and corporations.

When it comes to working wellness into your workforce, you want someone who knows the ins and outs of health promotion, and who can counsel staff members and provide primary care – all within the context of the current regulatory and legal environment.

AAOHN’s survey reported that more than 50% of staff members (61 percent) want to receive health and wellness information from a health care professional, such as a consultant or an worksite occupational health nurse (OHN), compared to pamphlets or brochures (18 percent) or human resources staff (15 percent).

OHNs can develop, start and evaluate components of work site Employee Health Promotion Programs such as testing programs, exercise/fitness courses, Stress Management Programs, tobacco use cessation, nutrition and weight control programs, as well as chronic illness management programs. Plus, OHNs can help staff members navigate through complicated health plans and may even serve as a triage point between staff members and their personal health care providers.

Employees might refrain from seeing their health care provider when it means time away from work, inconvenient parking, waiting time in the office and co-pays. In situations where staff members are under treatment for chronic diseases like heart disease, worksite nurses can routinely monitor risk factors such as blood pressure or cholesterol on a regular basis.

It’s often easier for an worker to ask an worksite nurse for information about symptoms or prescription medication than it is to schedule a follow-up visit to a personal health care provider. Advantages realized by corporations include improved worker morale and retention, a recruitment advantage, raised productivity and decreased time away from work.

In corporations with a safety department, the OHN can evaluate and address work-related health issues, including participation in workstation evaluations to correct potential ergonomic problems, and proactively addressing muscle strains by developing stretching programs and involving staff members in leading stretches.

Good for waistlines & your bottom line

By Sandra Simpson, APRN, BC, COHN-S, manager in Occupational Health Services at a Fortune 500 organization in Memphis, Tenn., and a member of the board of directors of the American Association of Occupational Health Nurses (AAOHN). For a copy of the AAOHN wellness survey, visit www.aaohn.org, or call (800) 241-8014, x0.

In today’s hectic world, most of us are spending more time at work, and have increasingly less time to look after our health. For a long time, corporations have understood the benefits associated with keeping workers well – raised productivity from decreased absenteeism and lowered disability claims. For these reasons, coupled with the fact that many corporations realized double-digit health care costs last year, corporations should consider Employee Health Promotion Programs as a way to keep staff members healthy.

But just how important are these programs to staff members? How often are they willing to take part in programs designed to positively impact their health and wellness? Who do staff members trust to provide them with important information about their health?

Answers to these questions and more were recently garnered from a study commissioned by the American Association of Occupational Health Nurses Inc. (AAOHN).

The AAOHN survey questioned 500 staff members nationwide about their perceptions of Employee Health Promotion Programs. More than three-quarters of all members indicated these programs are a good way to improve their overall health, and nearly 60 percent consider these offerings an incentive to remain with their current employer. worker retention and turnover impact the bottom line, so building Employee Health Promotion Programs into the work site culture is a valuable way to help retain talented staff members in addition to enhancing personal health and worksite productivity.

Health wish list

Employees appear to have their own agenda when it comes to their health. With new economic pressures, national security threats and work/balance issues, it’s not surprising that 85 percent of survey respondents cited Stress Management Programs as a priority topic for work site wellness.

In addition to stress, other preferred topic areas include testing programs (84 percent), exercise/physical fitness programs (84 percent), health insurance education (81 percent) and disease management seminars (80 percent).

In addition to lifestyle and personal health issues, those asked expressed concern about work-related health issues, including strains and injuries resulting from lifting or task-oriented muscle repetition, exposure to harmful substances, personal injury, vision changes due to computer work and worksite violence.

What you should do

With such a broad range of health concerns, a primary goal for corporations is finding a way to proactively address the health/wellness needs of the largest number of staff members, and effectively change unhealthy behaviors, promote wellness and ward off disease and illness.

Printed materials such as brochures, posters, fliers or pamphlets present an easy solution. But it’s important to remember that different employees require different formats for learning. A good rule of thumb: provide information in a variety of learning formats such as videos, pamphlets, health-related quizzes, display boards, Lunch-and-learn presentations and reimbursement or incentive programs.

This assumes you’ve overcome the first hurdle – getting employees to sign on to a Employee Health Promotion Program. While survey respondents indicated health and Employee Health Promotion Programs are important, just six out of 10 (60 percent) reported that they participated in the Employee Health Promotion Programs at their corporations. The other 40 percent cited lack of interest and lack of time as deterrents.

This points to the need for a broad-based, structured Company Health Promotion Initiative using a innovative approach, with an incentive for participation and effective program marketing.

By investing in an organized Company Health Promotion Initiative headed by a qualified health care professional such as an worksite nurse, corporations can give staff members the access to the health information they want, and increase participation and generate interest at the same time.

The result: staff members become savvier health care consumers who feel more in charge of their personal health. And healthier staff members make for a healthier bottom line.

Stress continues to drive staff members’ work-related health concerns, which is probably why most respondents (78 percent) in a recent survey claim they would take part in a Company Health Promotion Initiative to help their overall health and wellness.

In a recent study commissioned by the American Association of Occupational Health Nurses, Inc. (AAOHN), 500 full-time staff members nationwide were interviewed telephonically.

“Today’s staff members are clearly dealing with a lot of pressures such as the effects of 9/11, an unstable economy, national security threats and work/balance issues. There is a real opportunity for corporations to serve as an ally to their staff members by providing them with resources to better manage their physical and emotional health – anything from stress management seminars to nutrition and exercise counseling,” says Deborah V. DiBenedetto, president of AAOHN.

Nearly 80 percent of respondents believe their health would improve if they were offered the right information and tools through a viable Employee Health Promotion Program.

Topping the list of most interesting Employee Health Promotion Programs cited by staff members is stress management (85 percent), closely followed by testing programs (84 percent), exercise/physical fitness programs (84 percent), health insurance education (81 percent) and disease management seminars (80 percent).

More than 50% of staff members (61 percent) would prefer to receive health and wellness information from a health care consultant or worksite nurse, compared to pamphlets or brochures (18 percent) or human resources staff (15 percent).